Between 2008 and 2015, there was an increase in the average out-of-pocket spending for maternity care among women with employer-based insurance, according to a report published in the January issue of Health Affairs.

Michelle H. Moniz, M.D., from the University of Michigan in Ann Arbor, and colleagues examined trends in cost sharing for maternity care among working women in employer-based plans before and after implementation of the Affordable Care Act (ACA).

The researchers found that average out-of-pocket spending for maternity care increased among women with employer-based insurance between 2008 and 2015 (from $3,069 to $4,569 for all modes of delivery); the increase was mainly driven by an increase in deductible payments. During the study period, the standardized cost of maternity care remained stable ($29,518 in 2008 to $29,314 in 2015) despite rising out-of-pocket spending. Out-of-pocket spending was higher for lower-income working women in 2008 to 2013 when controlling for potential confounders; due to a continued increase in spending among higher-income working women, the disparities disappeared in 2014 to 2015.

"Our findings suggest that women with employer-based insurance continue to have substantial out-of-pocket spending for maternity care after implementation of the ACA," the authors write. "State and federal policy makers should consider implementing policies to restrict cost sharing for maternity care."

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